All treatment of periodontal disease must be preceded by a thorough evaluation of the patient’s general health. Certain illnesses or conditions can affect the response to periodontal therapy. As well, the delivery of treatment may adversely impact the health of certain patients.

Non-surgical treatment

Non-surgical treatment is most effective in the early stages of the disease process. This approach focuses on the control and removal of bacteria. Thorough instruction in oral hygiene procedures enable the patient to control the daily build up of bacterial plaque.

Professional removal of plague and calculus and smoothening of rough root surfaces, is then performed. These procedures are called scaling and root planing. Antiseptic mouthwashes are often recommended and in some cases antibiotics may be prescribed. An evaluation of the diet, condition of existing fillings, the patient’s bite, or other factors may be performed.

Surgical treatment of periodontal disease

Pocket reduction therapy:
Surgical therapy may be indicated in the moderate to advanced cases of disease, where bone loss has lead to the formation of deep infected pockets around the teeth. One goal of treatment is the reduction of these deep pockets, As with non-surgical therapy, additional evaluations and medications are often included in the management of these infections.

Regeneration of bone:
In the past, the loss of gum and bone support for the teeth was irreversible. Scientific advances utilizing sophisticated surgical techniques and new products and materials now make it possible to regenerate this lost tissue. Surgical procedures are used to clean out the infection from within the bone, followed by placing bone, bone substitutes, or special proteins into the damaged bone, which eventually become the patient’s own bone.

Bone grafts
Grafts involve implanting bone taken from elsewhere in the patient’s mouth, or obtained from donor tissue banks. In addition, processed animal bone or synthetic products, may also be used as grafting materials

Enamel matrix proteins
Some years ago experiments in Europe demonstrated that proteins obtained from newly forming teeth in laboratory animals could stimulate the human body to regenerate lost bone. These proteins are now available in the United States under the trade name Emdogain, the latest and most exciting product in the area of regeneration.